Healthcare Provider Details

I. General information

NPI: 1760397673
Provider Name (Legal Business Name): ADAM PURCELL LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 W BANK DR STE 201A
BOISE ID
83705-2573
US

IV. Provider business mailing address

3659 S CREEKWOOD WAY
BOISE ID
83709-6072
US

V. Phone/Fax

Practice location:
  • Phone: 208-495-6513
  • Fax: 208-279-0517
Mailing address:
  • Phone: 208-495-6513
  • Fax: 208-279-0517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ADAM PURCELL
Title or Position: LCSW
Credential: LCSW
Phone: 208-495-6513